Implants and Periodontitis: Why They Aren't a Good Match

Dental implants in Worthington, Ohio, can be an ideal solution if you're missing one or several teeth. Unlike other dental procedures, implants replicate the structure of your natural teeth and attach to your jawbone. This allows them to offer enhanced stability, durability, and an unparalleled ease of use.  

Although dental implants are a popular way to replace lost teeth, the health of the surrounding tissues determines how well they work. Because periodontitis can affect both soft tissue and bone, this poses special difficulties for those who have it and are considering implant dentistry.  

Here is our guide to helping you understand the relationship between periodontitis and implants and preventing unwanted consequences.

What Is Periodontitis and How Does It Affect Your Mouth?

Periodontitis is a severe form of gum disease that goes beyond gingivitis (mild gum inflammation). It is brought on by a bacterial infection that causes acids, which can inflame your gums and eventually cause them to recede.  

Over time, this condition can erode the alveolar bone and soft tissues around it, resulting in tooth loss and, ironically, prompting patients to think about getting implants.

Some typical signs of periodontitis are:

• Red, swollen, or bleeding gums

• Bad breath that doesn’t go away

• Gum recession or teeth appearing longer

• Loose or shifting teeth

• Pain when chewing

Unfortunately, because of the loss of bone density, the same condition that causes tooth loss can also make it more difficult to replace those teeth with implants.  

How Periodontitis Affects Bone Density

Dental implants are artificial roots that replace a missing tooth or set of teeth. Made of strong materials like titanium, implants are placed straight into the mandible to imitate the structure of a natural tooth. After the jawbone and implant have fused, a periodontist fixes the gap in your smile with a natural-looking restoration, such as a crown, bridge, or denture.

With proper care and good oral hygiene habits, implants can last many years to come. However, inflammation caused by periodontitis around implants affects both short-term healing and long-term stability, especially in people with a history of periodontal disease.

As the disease progresses, the alveolar ridge resorbs, and the periodontal ligament attachment is lost, decreasing bone volume and complicating osseointegration. This makes it more difficult for patients to get implants.

The severity and length of periodontitis determine the amount of bone lost. According to a review published in the Journal of Clinical Periodontology in 2021, patients with periodontitis can experience up to 2.5 mm vertical bone loss compared to those with healthy gums.

How Periodontitis Affects Implant Healing

Periodontitis weakens bones and alters the composition and structure of the soft tissues surrounding them. Extended inflammation can lead to fibrosis, reduced vascularization, and poor healing, all of which can hinder implant integration.

Even healed tissues that have previously been inflamed or damaged may heal more slowly after surgery. In addition to a longer recovery period, this may cause a delay in the implant loading procedure (when the crown or denture is attached).

Additionally, patients with a history of periodontal infection are more likely to develop peri-implantitis later on, even if their implant placement went well. To avoid this, routine dental examinations and rigorous oral hygiene are crucial for people with this issue.

How Periodontitis Causes Inflammatory Lesions

Peri-implant tissue inflammation is a condition caused by bacterial accumulation at the implant-abutment interface. Some signs of it include tenderness, swelling, and deeper probes.

Inflammatory lesions develop differently in implants than in natural teeth. Implants don’t have a periodontal ligament, the natural cushion that connects teeth to the jawbone. This ligament helps distribute forces and contains blood vessels and immune cells to fight infection. Bacteria can move down along the implant surface without the ligament.

Additionally, connective tissue fibers run parallel to the implant surface rather than perpendicularly, unlike in natural teeth. This results in reduced blood supply (vascularization) in the area. With less blood flow, fewer immune cells reach the site to fight bacteria.  

How Periodontitis Fosters Bone Infections

As inflammation worsens, the epithelial seal becomes more permeable. The epithelial seal is the body’s first line of defense between your implant and the outside world (in this case, your mouth full of bacteria).

When this seal becomes more permeable due to ongoing inflammation, it stops being a reliable barrier, allowing bacteria to penetrate deeper. And because there is no "buffer zone," the body may resorb inflammation quickly once it reaches the bone.

Moreover, titanium particles released from implant surfaces due to wear or corrosion can exacerbate inflammation, increase the risk of peri-implant disease, and cause further tissue deterioration.  

Making Implants Possible for Patients with Periodontitis

Periodontal disease can severely reduce your chances of getting implants—but there still is a chance.

You could become a candidate for dental implants with treatment to stabilize your oral health. To ensure this, we’ll recommend treatments such as scaling and root planing (deep cleaning), antibiotic therapy, and even gum grafts, if necessary.

Additionally, patients with a history of periodontitis who are considering dental implants can increase their chances of success by:

• Get the Disease Under Control First: Work with a periodontist to eliminate all signs of active infection before considering implants.

• Maintain Excellent Oral Hygiene: Brush twice a day, floss daily, and consider using an antibacterial mouthwash or water flosser.

• Stay on a Maintenance Program: You’ll likely need to see your dentist every 3–4 months for deep cleanings and check-ups.

• Choose an Experienced Provider: Look for a dentist or surgeon with experience placing implants in patients with a history of gum disease.

• Be Realistic About the Timeline: This won’t be a one-and-done procedure. Expect a phased approach with possible bone grafting, healing periods, and close monitoring.

Get Dental Implants in Worthington, Ohio, Safely and Successfully  

Dental implants are a popular replacement for missing teeth because they offer many benefits over traditional dentures or bridges. However, having a healthy mouth is critical to successfully undergoing a dental implant procedure. Without proper oral health, the implant may fail, requiring a replacement. In worst-case scenarios, a bone infection could occur.

To prevent these issues, your oral surgeon at Spectrum Dental & Prosthodontics will conduct a detailed assessment of your oral health and ensure you’re a good candidate for this procedure. If you’re interested in learning more, contact us today to schedule an appointment!